We all want to look and feel our best. Cosmetic dermatology is the science of treating skin to produce an aesthetic improvement. For some this may mean removing some brown “sun spots” on their face, for others this may mean a regimen of Botox injections and dermal fillers to maintain a youthful appearance. Every patient’s cosmetic goals are unique, so Dr. Pennie works with each patient to design a treatment plan to achieve those goals.
Dr. Pennie is committed to giving her patients the best results. The science of cosmetic dermatology is a continually advancing field so she regularly attends national meetings to bring the latest treatments to her patients. She will continue to offer new cosmetic treatments to meet her patients’ needs.
While many cosmetic procedures are widely available, they are still medical procedures and do carry some risk. As a board certified dermatologist, Dr. Pennie has specialized training in cosmetic treatments and is able to manage complications should they arise.
Dr. Pennie offers the following cosmetic procedures in her practice:
- Botox injections
- Dermal fillers (Radiesse® / Juvederm ®)
- Sclerotherapy (Leg Vein Removal)
- Chemical Peels
- SCITON Broadband Light (BBL™)
Cosmetic dermatology treatments are typically elective procedures and are not covered by insurance. At Pennie Dermatology, we will work with you to create an individualized plan that will give you the maximum benefit for your budget.
BOTOX® Cosmetic is an injectable treatment used for the rejuvenation of the skin. It is a naturally purified protein that relaxes the muscles of facial expression giving you a smooth, relaxed and youthful look. The procedure is quick, very well tolerated and results typically last for three to four months.
What can Botox be used for?
Before & After
- Frown lines or worry lines
- Periorbital wrinkles or Crow’s feet
- Brow lift
- Drooping mouth corners
- Brow asymmetry
- Lip wrinkles
- Platysma stranding or “neck banding”
- Chest wrinkles
- Bunny lines
- Masseter hypertrophy or softening of the jaw line
- Horizontal creases on the forehead
- Hyperhidrosis or severe sweating of the underarms, palms or feet
What is Botox?
Botox is a purified protein found in nature. It is a neuromodulator. What that means is that Botox blocks the attachment of the neuro- transmitting chemicals that are released by nerves at the neuromuscular junction to make a muscle move. As a result, the impulse from the nerve to the muscle is blocked. The clinical result is a decrease in the movement of the muscle and that causes a decrease in the wrinkling of the skin overlying that muscle. Botox is not a filler, but is often used in conjunction with fillers to reshape the face. Botox relaxes and fillers fill. This is an important difference.
Where is Botox used?
Botox is FDA approved for treatment of frown (glabellar) lines between the brows. Being FDA approved means Botox has been studied and found to be both safe as well as effective. Dermatologists often use Botox for other “off-label” uses as well. Botox improves not just frown lines, but also crow’s feet and forehead lines.
Botox can be used to achieve a chemical, non-surgical brow lift when certain muscles are injected. Botox can improve jaw line definition when injected into a neck muscle called the platysma. Botox can also be safely used to decrease excessive sweating of the hands or under the arms from medical conditions such as hyperhidrosis, or cosmetically for special, but stressful, situations like weddings.
Who can get Botox?
Botox is commonly used in a wide age range of patients: from 18-65. Patients over 65 can use Botox, but loose skin overlying the muscles make the improvement less dramatic. Botox effects usually last 4 months, but over time a cumulative benefit can be seen in younger patients.
Who performs Botox?
Dr. Pennie and her team of Physician Assistants, Megan Reisman and Jennifer Norman, perform Botox injections on their patients. It is imperative that Botox procedures are performed by a qualified provider with experience in cosmetic injectibles. This is the best way to safely ensure a great outcome and make sure you receive the best possible results without complications.
Now featuring Xeomin
XEOMIN® (incobotulinumtoxinA) for injection, for intramuscular use, is a prescription medication that is injected into facial muscles for the temporary improvement in the appearance of moderate to severe glabellar lines (frown lines) in adult patients.
Dermal fillers are substances that are injected into the skin to replace lost volume that comes with aging. Dermal fillers are typically used to fill the lines around the mouth (smile lines) but can also be used to fill the cheeks, lips, under the eyes, chin, temples, earlobes and hands. The recent addition of lidocaine to some fillers makes the injections more comfortable. Occasionally, some patients may have bruising after the procedure but many patients have no downtime.
What is Juvederm®?
Juvederm Ultra and Juvederm Ultra Plus are made of hyaluronic acid, which is a naturally occurring polysaccharide (sugar) found in the skin and joints. It is responsible for skin turgor (tone and “spring”) and it decreases from age and sun exposure, causing the skin to sink in and look older from the lines, folds and shadows.
Juvederm is a soft hyaluronic acid that results in a very natural correction. One of the reasons that Juvederm is so safe and popular is that if anything goes wrong, it can be completely dissolved by hyaluronidase. This makes Juvederm one of the safest and most versatile fillers on the US market.
Where can Juvederm® be used?
The FDA has found that Juvederm is a safe and effective treatment for facial lines and folds, such as nasolabial folds (smile lines). Juvederm can also be injected “off label” into the lips. Juvederm is a very soft hyaluronic acid filler that looks very natural. The most common side effects of lip injections are swelling and bruising. These are temporary and will last 2-7 days. It is important to avoid aspirin and other blood thinners like fish oil for 2 weeks prior to injection to decrease the risk of bruising.
Who can get Juvederm®?
Juvederm patients can be as young as their early 20’s (usually for lip augmentation) or as old as their eighties (for fine lines around the mouth), but the usual the patient is between 30 and 60. When Juvederm is combined with Botox the aging face can be softly and naturally reshaped without cutting or downtime.
Chemical Peels are a facial treatment that will significantly improve the texture of your skin by removing the damaged outer layers of skin. Chemical peels can improve skin that is blotchy, discolored, sun damaged or acne scarred. They are also a cost effective way to improve the look and feel of your skin.
How do chemical peels work?
A chemical peel works as a resurfacing technique that removes the top layers of the skin by means of a chemical, as opposed to heat with a laser. The chemical is chosen based on the skin type and color of the patient as well as the skin problem being treated. Acne, aging, and discoloration are the usual indications for a chemical peel. New skin is laid down so that pores appear smaller, small lines are plumped up and seem to disappear and acne and acne discoloration are improved.
Who can get a chemical peel?
Just about anyone is a candidate for a chemical peel. There are peels for everyone: lighter, less aggressive peels for darker skin suffering from acne or discoloration, and more aggressive peels for older skin with wrinkles and discolorations. The downtime can vary from no downtime to a week of peeling like a bad sunburn.
What can I do to get the best results from a peel?
Starting a good skin care regimen before a peel can improve your results. We recommend twice daily antioxidant, sunscreen in the morning and a retinoid in the evening. You should stop the retinoid one week prior to the peel and restart it one week after. Those with problems with melasma or hyperpigmentation should start a skin lightening cream (hydroquinone) several weeks before a peel. Keeping the skin moist to avoid crusting and always avoiding the sun after peeling are good practices. These things will prevent redness, infection and hyperpigmentation (brown spots).
LATISSE® solution is a prescription treatment for hypotrichosis used to grow eyelashes, making them longer, thicker and darker. Eyelash hypotrichosis is another name for having inadequate or not enough eyelashes.
What is LATISSE®?
LATISSE® is the only FDA-approved treatment that grows lashes longer, fuller and darker. There are many eyelash treatments available, but only LATISSEâ is FDA-approved for safety and efficacy. The active ingredient in LATISSEâ® is bimatoprost, which has been use for many years to treat elevated intraocular pressure. While on this medication, many patients noticed they had longer, fuller and darker lashes.
How is LATISSE® used?
It comes in a small bottle, like a bottle of eyedrops. Using a thin brush, you apply it nightly to your upper lid, at the base of the lashes, similar to how you’d apply liquid eyeliner. For best results, LATISSE® needs to be used once a day for 16 weeks. Using LATISSE® more than once a day will not grow your lashes faster or improve the effectiveness of the product.
Are there any side effects with LATISSE®?
The most common side effects after using LATISSE® solution are an itching sensation in the eyes and/or eye redness. Some patients have also reported eyelid redness and darkening of eyelid skin. There have been no reported changes to eye color with the use of LATISSE®.
How soon will I see results?
The effects with LATISSE® are gradual, some may start to notice longer lashes after about a month and many should experience full results in approximately four months (16 weeks). This is similar to the clinical trial results, but individual results may vary. Just like it takes some time for LATISSE® to work, if use of LATISSE® is discontinued, eyelashes will return to their previous appearance over the course of several weeks to months.
Sclerotherapy is a technique in which a very fine needle is used to inject a solution such as Ascleraâ, directly into the blood vessel. This solution causes an inflammation of the cells that line the vein. In response, the veins close up and collapse, no longer visible on the surface of the skin. The procedure itself takes just a few minutes and the veins disappear in 4 to 6 weeks.
What can I expect with sclerotherapy?
Sclerotherapy typically involves several sessions. These sessions are spaced at 4-8 week intervals to allow the sclerosis process to be fully complete. Compression of the vessels immediately after treatment facilitates the closure of the vessels, prevents pain, and prevents any risk of unusual complications like phlebitis (inflammation of the veins). The vessels injected gradually fade over several weeks. The winter is an ideal time to be treated since the stockings look more fashionable, like leggings! The length of time that the compression stockings must be worn depends on the size of the vessels injected.
People resume normal activities immediately. And there is no need for them to go home and put their feet up or be incapacitated in any way. The good news is that sclerotherapy offers relief to just about anyone. However, there may be cases that need more aggressive treatment for their leg veins. Ambulatory phlebectomy and invasive laser treatment such an endovenous closure may be necessary for severe cases.
What is Profile BBL broadband light?
BBL™ broadband light innovative technology sets new standards for the treatment of skin conditions associated with aging, active life-styles and sun damage. BBL broadband light energy allows your physician to precisely treat fine wrinkles, age & sun spots, small facial veins and several other skin blemishes. Your treatment will be tailored to match your skin’s condition and your desired results.
What will BBL™ treatment do?
BBL™ broadband light technology utilizes the power of pulsed light to deliver excellent results in photorejuvenation therapy. By selecting the appropriate wavelength or filter, your physician will be able to treat a broad range of skin conditions caused by skin aging and sun exposure. Your skin will be smoother, more vibrant and it will have a more youthful appearance as a result.
How does BBL™ work?
The light energy delivered by the BBL™ will gently heat up the upper layers of your skin. The heat absorbed by the targeted areas will stimulate your skin cells to generate new collagen. This will help restore your skin to its natural beauty, blending its natural colors and making it smoother, vibrant and younger looking. In addition the photothermal energy will target and eliminate many of the fine vessels that cause redness and the unwanted melanin responsible for pigmented lesions.
What areas can be treated?
Any area of your body can be treated. The most common areas are those most exposed to the damaging effects of sun light. The most popular treatments are for the face, neck, back of the hands, chest and shoulders.
Source:: Before/After | 1 tx | courtesy of Catherine Fisher,MD - BBL™ Parameters: 515 nm filter, 12 J, 15 MS, 15°C Cooling
Source:: Before/After | 1 tx | courtesy of Catherine Fisher,MD – BBL™
Parameters: 515 nm filter, 12 J, 15 MS, 15°C Cooling
How long will it take to recover?
This is a non-invasive and gentle procedure with virtually no down-time. In most cases you will be able to return to work, apply makeup, and resume most of your activities right away.
What will my treatment consist of?
Getting Started: Our physicians in a consultation determine an BBL™ treatment plan for each new patient, accounting for the number and severity of skin conditions being treated, as well as skin type. On average, four to six treatments are recommended, scheduled at three week intervals. Each session usually lasts about 20 minutes, with patients returning to normal activity immediately afterwards.
What to Expect
The procedure is gentle, non-invasive, and safe. There should be minimal or no discomfort, however this varies from patient to patient and depends on the depth of the treatment. An anesthetic cream applied 45 minutes prior to your treatment, may be used if so desired to minimize any treatment associated discomfort. Your physician will recommend the best options during consultation.
Before treatment, a cold gel is usually applied to the areas to be treated and patients wear protective eyewear. During treatment, we gently applies the smooth, glass surface of the BBL™ hand piece to the skin. Light is delivered to the skin surface in precise pulses across the treatment area. Patients often describe a slight stinging sensation, like the snapping of a rubber band, in the treated areas. Most individuals find this to be very tolerable. Your procedure may take a few minutes to half an hour depending on the size of the area to be treated and the type of the procedure performed.
What will I look like immediately after BBL™ treatment?
BBL™ treatments are designed to provide little down time. Your face may appear red or flushed, something which usually fades within a few hours. Individuals with prominent pigmentation may notice that brown areas become temporarily darker, peeling off in 10-14 days. Makeup may be applied immediately after your treatment so you can return to your daily activities. By performing microdermabrasion between IPL sessions, recovery may be enhanced and results may be improved.
Rarely, some individuals develop “purpura” or bruising. Although uncommon, this sometimes occurs in individuals with a very prominent red component. This is painless and typically fades in about 5-10 days. Any bruising may be covered with makeup.
Individuals with prominent brown or red color may develop slight temporary swelling for a few days, especially if being treated around the eyes.
How do I care for my skin after the treatment?
It is important to follow your physician’s instructions. We will recommend skin care products and provide instructions on how to use them. These will minimize your risk of inflammation or redness and ensure the shortest healing time.
Following treatment, ice may be applied to the treated area if desired.
Medications containing aspirin or anti-inflammatories (Aspirin, Motrin, Advil, Ibuprofen, etc.) should be avoided for a couple of days before and after BBL™ treatment.
Strenuous exercise and contact sports should be avoided for a few days.
Alcohol intake should be limited. This will help to reduce the risk of trauma and bruising.
Within weeks, your treated skin will feel smoother, fine wrinkles and pores will be less noticeable, and sun spots or uneven pigmentation will fade. Results depend on your condition, the number of treatments, and the area treated. Your physician will provide you with complete information about the post treatment care and results.
Source: Before/After | 12 days post 2x | courtesy of Brian V. Heil,MD BBL™ Parameters: 515 nm filter, 15°C Cooling
Source: Before/After | 12 days post 2x |
courtesy of Brian V. Heil,MD
Parameters: 515 nm filter, 15°C Cooling
You will be sensitive to ultra-violet light and you must avoid direct sun exposure until fully healed. Sun tanning and tanning beds should be avoided for 1 month before and after each BBL session. A broad spectrum sunblock with zinc oxide and/ or titanium dioxide as the primary ingredients should be used on a daily basis.
Learn More About
Broadband Light (BBL) photorejuvenation for unwanted brown and red in the skin.
Acne Laser Treatments
Laser Hair Removal